Clinico-pathological Features of Gynecological Malignancies in a Tertiary Care Hospital in Eastern India: Importance of Strengthening Primary Health Care in Prevention and Early Detection

Madhutandra Sarkar,Hiralal Konar,Deepak Raut

doi:10.7314/apjcp.2013.14.6.3541

Madhutandra Sarkar, Hiralal Konar + Show 1 more

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https://doi.org/10.7314/apjcp.2013.14.6.3541

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Abstract

This cross-sectional observational study was undertaken to establish clinico-pathological characteristics of patients with gynecological malignancies, focusing mainly on symptoms, histological type and stage of the disease at presentation, in a tertiary care setting in Eastern India. In the gynecology out-patient clinic of a tertiary care hospital in Kolkata, India, the patients with suggestive symptoms of gynecological malignancies were screened. Their diagnoses were confirmed by histopathology. One hundred thirteen patients with histopathologically confirmed gynecological malignancies were interviewed. The most frequently reported symptoms by the patients with histopathologically confirmed gynecological malignancies were excessive, offensive with or without blood stained vaginal discharge (69.0%), irregular, heavy or prolonged vaginal bleeding (36.3%) and postmenopausal bleeding (31.9%). The majority of the patients (61.0%) had squamous cell carcinoma on histopathological examination, followed by adenocarcinoma (30.1%). Nearly half of the patients (48.7%) were suffering from the Federation Internationale des Gynaecologistes et Obstetristes (FIGO) stage III, followed by stage II (40.7%) malignancy. This study highlights that most of the patients with gynecological malignancies present late at an appropriate health care facility. Ovarian cancer may often have non-specific or misleading symptomatic presentation, whereas cervical cancer often presents with some specific symptoms. These observations point to the need for increasing awareness about gynecological malignancies in the community and providing easily accessible adequate facilities for early detection and treatment of the disease by optimal use of available resources, i.e. strengthening the primary health care system.

Highlights

This cross-sectional observational study was undertaken to establish clinico-pathological characteristics of patients with gynecological malignancies, focusing mainly on symptoms, histological type and stage of the disease at presentation, in a tertiary care setting in Eastern India
Gynecological malignancies are a group of different malignancies of the female reproductive system (Senate Community Affairs References Committee, Commonwealth of Australia, 2006), which include cancers of the ovary, cervix and body of the uterus, vulva, vagina (Department of Health, Social Services and Public Safety, Northern Ireland, 2002; Senate Community Affairs References Committee, Commonwealth of Australia, 2006), and gestational trophoblastic neoplasia (GTN) (Dutta, 2003)
Carcinoma of the cervix remains to be the leading cause of death from cancer among women in the developing countries (Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, 2005), with more than 80% of the cervical cancer cases occurring in this part of the world (Sankaranarayanan and Ferlay, 2006)

Summary

Introduction

Gynecological malignancies are a group of different malignancies of the female reproductive system (Senate Community Affairs References Committee, Commonwealth of Australia, 2006), which include cancers of the ovary, cervix and body of the uterus, vulva, vagina (Department of Health, Social Services and Public Safety, Northern Ireland, 2002; Senate Community Affairs References Committee, Commonwealth of Australia, 2006), and gestational trophoblastic neoplasia (GTN) (Dutta, 2003). The most confirmatory test for the diagnosis Study tools of malignancy is considered to be histopathological i) A pre-designed and pre-tested checklist and a preexamination of tissue specimens, according to the designed and pre-tested schedule, ii) Hospital records, publications by the same authors, it is seen that iii) Past health records of the patients, iv) Investigation identification of certain epidemiological factors and reports, histopathology reports, v) Cusco’s warning symptoms of gynecological malignancies may bivalve self-retaining vaginal speculum, vi) Stethoscope be helpful in early diagnosis of these cancers Before starting of the study on 10 patients and necessary modifications were made and these were

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Discussion